Thyroidectomy: is it safe to be performed by general surgery residents? - single centre experience.

ABSTRACT

BACKGROUND: Thyroidectomy carries a risk of two crucial complications - recurrent nerve palsy and hypocalcaemia. The aim of the study was to assess the safety of thyroidectomy performed by general surgery residents. METHODS: Data of 515 patients, who underwent total thyroidectomy between the years 2015 and 2019, were prospectively collected. Inclusion criteria were as follows age >18 years old, patients who underwent total thyroidectomy, no change of operator during the surgery. The study group was divided into two groups operated by general surgery specialists (385 patients-group 1) and operated by residents with the supervision of experienced general surgery specialists as assistants (130 patients-group 2). RESULTS: Demographic factors did not differ statistically between groups. Median operative time was 65 min (55-85 IQR) and 90 min (75-110 IQR) in groups 1 and 2, respectively (p < 0.001). Complications occurred in 97 (18.7%) patients in group 1 and 25 (19.3%) patients in group 2 (p = 0.893). Recurrent nerve palsy diagnosed with laryngoscopy was the most common complication - 10.2% and 9.2% of patients, respectively (p = 0.754). Permanent vocal paresis occurred in 2.3% and 3.2%, respectively (p = 0.786). Postoperative symptomatic hypocalcaemia occurred in 7% of patients in group 1 and 10% of patients in group 2 (p = 0.271). Logistic regression did not show that resident as the operator with or without intraoperative neuromonitoring is a risk factor for any complications. CONCLUSION: The results of the present study show that thyroidectomy performed by a general surgery resident under supervision can be as safe as the one performed by a specialist.